Registered Dietitian Can Weigh Restrictions

ADVICE

Q. I have been told my blood cholesterol is elevated and that I am anemic. Each of these problems has brought with it dietary modifications. I now have several diet lists to follow, and many of the foods allowed on one list are not permitted on another. As a result I am left with very few foods to choose from. Can you give me an idea of what I really can or cannot eat?

A. Not without specific information about your medical condition. But what we can do is to point you in the direction where help lies: a registered dietitian. When you make your appointment, the first thing she or he will do is to check with your current physician to determine which of these dietary adjustments are still necessary, which can be liberalized and if some can even be abandoned.

The type of problem you describe is common. Many people are placed on a special diet for some type of medical condition, and as time goes by continue to follow a restrictive regimen well beyond the point that it is needed.

Ulcers are an excellent example. People may assume that once the problem has occurred a diet is always necessary and never bother to ask about a reasonable approach after the ulcer has healed. Yet research has led to broad changes in ideas about effective dietary treatment. Over the past 20 years, complicated regimens for active ulcers have generally been abandoned in favor of more liberal advice to eat small amounts of food regularly and avoid any that causes symptoms. Only a few foods, among them black pepper, chili powder, coffee, tea and cocoa have been shown to cause ulcer symptoms consistently. Alcohol, of course, is a gastric irritant.

Ironically, some individuals whose conditions improved long ago may be following more restrictive diets than some recently diagnosed as having the same condition. If you have several problems requiring dietary modifications, it is a good idea to review the need for each of them periodically. No one wants to follow more restrictions than are needed.

For your current situation, there are several ways to find professional help. Your doctor may work directly with dietitians who do patient counseling. The Dietetic Association in your state may maintain a listing of dietitians who offer private consultations. The dietary department of your local hospital may also provide these services, or if they do not, may be able to refer you for professional help.

Q. I have looked in several charts to find out how many calories are in a bagel. They vary surprisingly, and I wondered why.

A. The variation is probably because the descriptions are of bagels of different sizes. Bagels in calorie charts we examined varied from just under 2 ounces to almost 3 ounces. Some we bought at a local bakery weighed almost 4 ounces.

In general, bagels contain about 80 calories an ounce. To learn how many calories you are consuming when you eat a bagel, you have to find out how much it weighs. If the bagels are packaged, you can easily determine weight by dividing the total weight of the package by the number of bagels it contains. If you buy them at a bakery, the baker may be able to tell you approximately how much one of his bagels weighs. If you are concerned about portion weights and don`t own a kitchen scale, we recommend you purchase one. Some are quite inexpensive, and we are sure that checking how much bagels weigh is the first of many uses you will find for it.

Have a consumer-oriented question? Dr. Jean Mayer and Jeanne Goldberg, a registered dietitian, are affiliated with Tufts University. Write to them at Washington Post Writers Group, 1150 15th St. Northwest, Washington, D.C. 20071.